Evidence-Based, Simplified Nutrition and Lifestyle Strategies


CIRS Symptom Clusters

CIRS Symptom Clusters

Chronic Inflammatory Response Syndrome (CIRS) is a complex medical condition characterized by an array of symptoms that can be overwhelming and confusing. Understanding the 13 symptom clusters associated with CIRS is crucial for both patients and healthcare professionals alike.


Let’s take a closer look into the details of these symptom clusters, exploring how they were established and why they play a pivotal role in the diagnostic process. By categorizing symptoms into distinct clusters, medical professionals can more effectively identify and diagnose CIRS, providing a clear path for targeted treatment strategies.


Here, we will go in-depth into the importance of each cluster and discuss how they collectively serve as a critical diagnostic criterion for CIRS.


What Is CIRS?



CIRS is recognized as a complex health condition characterized by widespread inflammation and diverse symptoms that impact multiple body systems, stemming from an overactive immune response. Accurate diagnosis of CIRS requires a detailed examination of the patient’s medical history and the use of specialized laboratory testing. The symptoms of CIRS vary widely among individuals, often leading to misdiagnosis or inappropriate treatment options. One of the primary challenges in diagnosing CIRS is that it does not manifest in standard autoimmune blood tests, necessitating the use of specific diagnostic techniques to properly identify this disorder.


what is cirs


What triggers the severe immune reactions and pervasive inflammation associated with CIRS? The main culprits are biotoxins—natural toxic substances with specific molecular weights, originating from a range of sources:


  • Water-damaged environments: Approximately 80% of CIRS cases are associated with exposure to air in water-damaged areas, which are rife with mold mycotoxins, bacteria, and various chemical irritants. These contaminants induce strong inflammatory reactions in those prone to CIRS, with both active and dormant mold components causing considerable inflammation in the body and brain.


  • Insect bites: Bites from specific types of ticks and spiders can lead to persistent conditions such as chronic Lyme disease, caused by pathogens like Borrelia burgdorferi and Babesia microti. Toxins from recluse spider bites may also lead to long-term health complications.


  • Seafood consumption: Consuming tropical reef fish contaminated with ciguatera toxin, often linked to Pfiesteria and harmful algae blooms, including cyanobacteria (blue-green algae), can result in biotoxin-related health issues. These toxins accumulate as larger reef fish consume smaller fish that have absorbed dinoflagellates.


  • Contact with contaminated water: Interaction with or inhalation of water contaminated with algae blooms, such as Pfiesteria and cyanobacteria, can trigger the inflammatory responses characteristic of CIRS.


  • Other biotoxin sources: Exposure to certain vaccines, viruses, volatile organic compounds (VOCs), endotoxins, and actinomycetes are other potential triggers for CIRS, each adding to the body’s load of biotoxins.


cirs water damaged building biochemical stew


Due to their minute molecular size, biotoxins can penetrate cell membranes, rendering them virtually undetectable in regular blood tests. These toxins often enter the body through inhalation, but they can also be absorbed through ingestion, tick and spider bites, and direct contact with contaminated water.


Exposure to common biotoxins like mold does not necessarily lead to CIRS; an individual’s genetic disposition and life stressors play a significant role in their vulnerability to biotoxin-related disorders. Events such as severe illnesses, surgical procedures, high fevers, pregnancies, substantial exposures to biotoxins, and other traumatic experiences can initiate a cytokine storm. This immune response may trigger the CIRS gene in genetically susceptible individuals, especially those with HLA-DR genes, indicating that CIRS can develop at any stage of life. Importantly, the absence of symptoms does not confer immunity, and genetic testing is crucial for preventative measures.


While biotoxins can induce immediate illness, the immune systems of most people are adept at detecting and eliminating these toxins. However, in individuals genetically predisposed to CIRS, their immune systems are unable to recognize and eliminate these toxins, which leads to their accumulation in the body. This results in a continuous, severe immune response and widespread inflammation, leading to various symptoms and ongoing health complications.


The biotoxin pathway explains why CIRS is a multi-system, multi-symptom condition, you can learn more about the biotoxin pathway here.


For a more detailed understanding of CIRS, click here.


What Are the Symptom Clusters for CIRS?


cirs symptom clusters


Since CIRS symptoms often overlap with other conditions, this symptom cluster list helps provide better diagnostic clarity. It’s important to note that having some of the symptoms doesn’t necessarily mean you have CIRS. For the diagnostic criteria, the symptoms have been grouped into 13 different clusters based on the implications of the biotoxin pathway.


Here are the following 13 symptom clusters and their respective symptoms:

  1. Fatigue
  2. Weakness, inability to retain new information, aches, headache, light sensitivity
  3. Memory impairment, decreased word finding
  4. Difficulty concentrating
  5. Appetite swings, irregular body temperature regulation, increased urinary frequency
  6. Unusual skin sensitivity, tingling
  7. Shortness of breath, sinus congestion
  8. Cough, excessive thirst, confusion
  9. Joint pain, morning stiffness, cramps
  10. Red eye, blurred vision, night sweats, mood swings, ice-pick pains
  11. Abdominal pain, diarrhea, numbness
  12. Eyes tearing, disorientation, metallic taste
  13. Static shocks, vertigo


How Are the CIRS Symptom Clusters Established?

These signs and symptoms are from published animal and human studies of mold-based illness. Dr. Shoemaker discussed the clusters based on observations, data, and correlations. Dr. McMahon, a Shoemaker practitioner, was able to prove having a certain number of symptom clusters served as diagnostic criteria for CIRS.


From a list of 37 different symptoms, there are eight main categories formed in an effort to classify symptoms. Since CIRS impacts various systems throughout the body, that’s why these symptoms are grouped in this manner.


Here are the eight main categories used for CIRS symptom clusters:

  • General
  • Musculoskeletal
  • Eye
  • Respiratory
  • Gastrointestinal
  • Cognitive
  • Hypothalamic
  • Neurologic


Cluster analysis provides a mechanism to take subjective symptoms, pass them through a skilled medical history, and then convert them to objective elements using abstruse statistical methods. Clusters can take the seemingly endless roster of symptoms to make their use amenable to a scoring system.


CIRS Symptom Clusters and Diagnosis


cirs diagnosis symptom clusters


The diagnostic criteria are having at least eight of the 13 clusters for adults and at least six of the 13 clusters for children. You just need to have one of the symptoms in a cluster for that entire cluster to be considered positive.


Adults who have at least eight of the 13 clusters and who fail the Visual Contract Sensitivity (VCS) test have a 98% chance of having CIRS.


CIRS Symptom Cluster Trends

Here are some CIRS symptom cluster trends that have been observed:

  • For CIRS patients, the average number of CIRS symptoms is more than 23 out of the 37 symptoms.
  • In over 30% of patients that have been recorded in Dr. Shoemaker’s office, all 37 symptoms were present.
  • CIRS cases for children and teens between the ages of 10 and 17 have an average of 12 symptoms.
  • CIRS cases for children under the age of 10 have an average of six to eight symptoms.
  • Sometimes very young children can only have one symptom. The most common symptoms in early pediatric cases include:
    • Headaches
    • Bedwetting beyond typical age ranges
    • General fatigue compared to other children of similar age
    • Stomach aches


Pro-Tip: When reviewing these symptoms, consider if you’ve had this symptom in the past or periodically even if it’s not present now. We’ve found that many in our Carnivore community may not have all eight positive symptom clusters currently as the diet can often band-aid some of these symptoms.


The Nuance Behind CIRS Symptom Clusters

Certain conditions and past symptoms can also qualify under each symptom category within each cluster. There is significant nuance behind these symptom clusters that can illuminate pieces of the puzzle for CIRS patients. For the remainder of this content, join our CIRS Support Group.


Closing Thoughts On CIRS Symptom Clusters

Understanding and identifying the 13 symptom clusters associated with CIRS are essential steps in the diagnosis and management of this complex condition. These clusters provide a structured way to capture the multi-system impact of CIRS, enabling healthcare providers to pinpoint the presence of the syndrome with greater accuracy. Accurate recognition of these symptom clusters not only aids in the diagnosis but also helps in differentiating CIRS from other conditions with similar presentations.


Throughout the treatment process, particularly when following the Shoemaker Protocol, tracking symptoms meticulously is crucial. This protocol, which is designed to eliminate biotoxins and mitigate inflammation, involves several stages and treatments, each with the potential to significantly alter symptoms. Systematic symptom tracking allows patients and healthcare providers to monitor the effectiveness of each treatment component, adjust strategies as needed, and gauge progress towards recovery.


VCS testing is a valuable tool in this journey, providing measurable data on neurological function that can be tracked over time. While VCS testing offers a quantitative method to monitor certain aspects of neurological health affected by CIRS, comprehensive symptom tracking remains equally important.


By maintaining detailed logs of symptoms, patients can help their healthcare providers distinguish between reactions specific to CIRS and those stemming from possible co-infections or comorbid conditions, which are common in CIRS patients. This detailed approach ensures that each symptom is correctly attributed and appropriately addressed, enhancing the overall strategy for managing and overcoming CIRS.


nwj cirs group


Pro-Tip: Are you looking for more in-depth practitioner resources and a like-minded community to support you through your CIRS journey? Join our exclusive CIRS Support Group for the latest research, step-by-step protocol tools, and support to successfully achieve root-cause healing.


Work With Our Trusted CIRS Practitioners

The Nutrition with Judy practice is honored to be trusted CIRS practitioners having served hundreds of clients and patients from around the globe. We’re passionate about helping our clients achieve root-cause healing in order to lead the best quality of life possible that’s nearly symptom-free. Our team is dedicated to helping CIRS patients navigate this complex illness. If you think you’re suffering from CIRS, start with our White Glove Service for comprehensive care.

Start your root-cause healing journey today and contact us any time with any questions or concerns.


DISCLAIMER: This content is for educational purposes only. While we are board-certified in holistic nutrition and are nutritional therapy practitioners, we are not providing medical advice. Whenever you start a new diet or protocol, always consult with your trusted practitioner first.

Nutrition with Judy

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